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The One Thing

Many complain that after a century of great results chiropractic should be more fully accepted by now. These same chiropractors use this observation to advance their pet notion of the one thing that would be needed to permit chiropractic to finally reach the tipping point.

What's your one thing?Their mistake is thinking that it’s just one thing that stands in the way.

Like Curly.

In case you missed it, actor Jack Palance was the crusty cowpoke Curly in the 1991 comedy City Slickers. Here’s the dialogue from the scene in which Mitch (played by Billy Crystal) learns about the one thing:

Curly: Do you know what the secret of life is?
Curly: This. [holds up one finger]
Mitch: Your finger?
Curly: One thing. Just one thing. You stick to that and the rest don't mean shit.
Mitch: But what is the "one thing?"
Curly: [smiles] That's what you have to find out.

We humans are always on the lookout for the “one thing.” But it’s rarely one thing. What has conspired to prevent chiropractic from flourishing, or your practice from thriving, isn’t one thing. Yet, many will bang their “one-thing” drum (which usually involves sending them money), claiming that resolving that one thing practice nirvana will result.

Here are some popular one-thing drums. “Fix this,” claims the drummer, “and chiropractic will finally assume its rightful place.”

The-10-different-recommendations-from-10-different-chiropractors drum.
The-lack-of-so-called-“scientific”-research-proving-chiropractic drum.
The-questionable-tactics-of-practice-management-coaches drum.
The-surrogate-testing-and-unproven,-experimental-techniques drum.
The-annual-care-plans-or-let’s-make-a-deal-fee-policy drum.
The-raising-requirements-for-admission-into-chiropractic-college drum.
The-high-cost-of-a-chiropractic-education-and-the-resulting-debt drum.

Oh, and don't forget the classic:

The-if-I-just-had-enough-new-patients-my-problems-would-be-over drum.

While these may be annoying, even unfortunate, they hardly rise to the “one thing” that promises the breakthroughs so many hope for. In fact, they are largely symptoms of far more fundamental issues. What has conspired against chiropractic from reaching societal authority and acceptance is largely out of anyone’s direct control:

The cultural influence of mechanism. We live in a culture that minimizes the spiritual and celebrates the physical. In truth, we are much more than a collection of “parts,” chemical reactions and a limited number of cellular replications!

Dogmatism among the earliest leaders. Without the strident beliefs and flamboyant personalities of the past, chiropractic probably wouldn’t have even made it this far. Whether you’re embarrassed by D.D. and B. J., or you revere them, without them, the chiropractic you enjoy wouldn’t even exist.

AMA boycott and the committee on quackery. The well was poisoned long before most of today’s chiropractors were even born. Reversing this bias, if even possible, will probably take at least another generation.

Drug advertising in the media. We live in a drug culture. The side effects and deaths caused by the pharmaceutical cartel is seen as “just the cost of doing business.” If the deaths-by-drugs figures were watched as carefully as the death toll in Iraq, things would be different.

Recipients of third party reimbursement. Being invited to “sit at the adult’s table” was wonderfully validating. Unfortunately, by following the money chiropractors gave up being whole-body health specialists in favor of becoming a medical subspecialty focused on back pain. Oops!

Erosion of third party reimbursement. Now, with the brokenness of the symptom-treating mentality of “health” care more pronounced, turns out back pain doesn’t rise to the threshold of a catastrophic health problem warranting reimbursement. Double oops!

The inconvenience of chiropractic. Asking patients to interrupt their lives and show up in your office is far less convenient than reaching into a purse and popping a prescription every so often.

There are probably others. Does that mean the situation is hopeless? Of course not. There are issues that members of the profession can address that could make a difference. Again, none of them by themselves will turn the tide, but with time, taken together, each could help:

Chiropractic as nerves rather than bones. Since bones are static structures, malpositioned bones are merely symptoms. Fascinating, but not that significant. Make chiropractic about the nervous system and watch things turn around.

Wanting to be accepted by the medical community. Fitting in, being liked and craving acceptance is so junior high. Be proud that you’re not part of the “in” crowd responsible for killing hundreds of people every day and being the third largest cause of preventable death.

Pervasiveness of disembodiment. Most people cannot “hear” their body until it literally screams with symptoms. Our culture is the manifestation of Descartes’ suggestion that the mind can be detached from the body. Helping patients reconnect would be a valuable public service.

Chiropractors ignoring chemical and emotional stressors. Most chiropractors focus on the physical stressors that produce the survival strategy we call subluxation. Most look past the far more pervasive chemical and emotional causes of subluxation.

Chiropractic colleges lacking endowments. Have you included your alma mater in your estate planning? Only when chiropractic colleges have some financial security will they be able to shun the path of least resistance, pandering for tuition dollars.

Ineffective patient teaching rather than patient education. I’ve written extensively about this for years. Most chiropractors tell rather than ask and call it patient education. It doesn’t work. Never has.

Focusing on new patients rather than referrals and reactivations. Falling for the trap of treating episodes of back pain, many chiropractors (and their patient’s) think of chiropractic care is a “diet” rather than a lifestyle. It shows up as a getting-new-patients problem. But it’s actually a patient-keeping problem.

It’s not one thing. It’s much more complex than that. However, take heart in the words of Mahatma Gandhi: “Be the change you want to see in the world.” One man. One simple idea. One thing.

Comments (3)

David Hansen:

I have the opposite problem. All the new patients and referrals I can handle. Some long term patients and many that come back the next time they "need" me. Not teaching chiropractic and nervous system well. Having trouble pushing past 30 per day.

R. Tyler Given, DC:

C'mon. I'm in San Diego County. I wasn't in the phone book for the last three years and am not on any insurance plans. None, nadda, zippo. And I had my best month in 2 years last month. What did I do? I just did my best for every patient. I told them their options, honored their decisions, and did my best. I also raised my fees a bit but don't think that was it.

I really don't get why so many are crying the blues.

Bob Wagner:

Chiropractic is coming down to one thing: Do you believe enough to be bivocational at this? Most Pastors, missionaries, and previous chiropractors held 2 jobs so that they could continue to render chiropractic or the gospel to those in need. Do you and I believe enough to go ahead and get another job so we can make ends meet and continue to provide chiropractic during the day while we work another job in the evening? Tough stuff to swallow but we are at that point in this profession. I now pay 5k in overhead a month to make 5k. If I want to go on I will have to get a part time job to make it viable. Tough stuff after 22 years at it. I believe we will see 50% of the chiropractors out there refuse to get another job and they will leave the profession. Maybe that is good and maybe not but a new practice is an oxymoron, unless mom and dad have got cash, it is not very profitable to go at it on your own anymore. I need to search myself to see how much I believe in this because it's time to move on or get a PT job to support
what I believe in.

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From September 6, 2007 6:01 AM

This page contains a single entry from the blog posted on September 6, 2007 6:01 AM.

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